NEJM Catalyst

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Barry Portugal

I disagree with NEJM's premise that "the loss of CSR payments would create some short-term chaos in the market as insurers raise premiums and leave some markets, but it would not significantly impact the number of people covered". The number of people who chose the Silver plans is estimated from about 5.8 million people by the Heritage Foundation; the Center on Budget and Policy Priorities put the number at about 5.6 million people. CSR varies from state to state. According to CBPP, in Florida where I live, about 1,200,000 people enrolled in the CSR program average about @1,200/year in savings. For NEJM to suggest that over 1.2 million people is not significant is simply wrong.

I urge NEJM to reconsider its position about the impact that reduced CSR payments will have on the people who need it the most.

It’s a generally accepted view that all hospital-employed physician groups are constitutionally incapable of operating without financial support from the hospital. PinnacleHealth Medical Group found that commonsense tactics can eliminate the need for hospitals to expend precious resources to support employed physicians.